Type 1 diabetes spikes among Philadelphia children, study finds

Disease incidence, stable for many years, skyrockets among children ages 0 to 4

PHILADELPHIA — While much of the attention to diabetes has focused on the dramatic rise of Type 2 diabetes among adults and children alike, a new study by a researcher in Philadelphia has found a spike in Type 1 diabetes among children as well.

University of Pennsylvania School of Nursing Professor Terri Lipman and a team of reasearchers found that the overall incidence of Type 1 diabetes in Philadelphia children younger than 5 years increased by 70%, and by 29% among children overall, between 1985 and 2004. The study appeared online in January in the journal Diabetes Care.

But while many hypotheses as to the causes for the increase had emerged, no risk factors had been confirmed, and Lipman said investigating risk factors was critical.

"The most rapid increase in Type 1 diabetes — in children diagnosed before age 5 — requires immediate attention," Lipman reported. "These young children are at the highest risk for death because of often-delayed diagnosis. The rapidly rising risk of diabetes in black children ages 0 to 4 years is of particular concern given the marked racial disparities that have been identified in diabetes outcomes and treatment in this population."

The study drew on data from the Philadelphia Pediatric Diabetes Registry, which Lipman has maintained since 1985 and which includes data on white, black and Hispanic children.

"The incidence of Type 1 diabetes in Philadelphia children has increased at an average yearly rate of 1.5%," Lipman said. "However, the incidence had been relatively stable over the first 15 years and has risen most markedly since 2000. The upward trend adds to the evidence of an increasing incidence of diabetes in the United States and worldwide."

According to racial and ethnic data, the incidence of the disease in white children had historically been stable, with about 13-per-100,000 diagnosed every year. However, between 2000 and 2004, there was a 48% increase. Hispanic children had been diagnosed at a rate of 15.5-per-100,000, but also saw a 27% increase.

For the first time, the Philadelphia registry from which the study data were taken also included cases of Type 2 diabetes. While the incidence of Type 1 diabetes is 18 times higher in white children than Type 2, it is only 1.6 times higher in black children, indicating a high incidence of the disease in that population. Historically, Type 1 diabetes was called "juvenile diabetes," and Type 2 was called "adult-onset diabetes," but those names have fallen out of favor as the latter has become increasingly common in children, largely due to the prevalence of unhealthy lifestyles and obesity.

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